The Battle over the DSM-5

By Christopher Shea

Here’s a juicy fight, courtesy of Wired: As you may know, the American Psychiatric Association is in the process of revising its Diagnostic and Diagnostic and Statistical Manual of Mental Disorders, aka the DSM-IV, soon to be the DSM-5 (the shift away from Roman numerals being among the least controversial revisions).

As it happens, the lead editor of the volume that’s about to be replaced, Al Frances, long retired from Duke Medical School, thinks the new edition of the psychiatric bible—due next year—will be an “absolute disaster.” In fact, he more than flirts with the idea that writing a diagnostic manual in his field is a mug’s game: “there is no definition of a mental disorder … I mean, you just can’t define it.”

The APA responds that the fight is largely about intellectual property, with Frances defending “his” book.

You don’t have to takes sides in the whither-the-DSM debate, however, to conclude that the goal of the APA’s director of research, as reported by Wired, may be a tad overambitious. Darrel Regier says he’s hopeful that “full understanding of the underlying pathophysiology of mental disorders” will someday establish an “absolute threshold between normality and psychopathology.” Between, say, crushing existential despair and clinical depression?